Dapagliflozin treatment for type 2 diabetes: a systematic review and meta‐analysis of randomized controlled trials. Issue 3 (March 2014)

• Record Type: Journal Article
• Authors: Zhang, Mei; Zhang, Lin; Wu, Bin; Song, Haolan; An, Zhenmei; Li, Shuangqing
• Is Part Of: Diabetes/metabolism research and reviews. Volume 30:Issue 3(2014:Mar.)
• Page Start: 204
• Page End: 221
• Publication Date: 2014-03
• Subjects: Diabetes -- Periodicals; Metabolism -- Periodicals; 616.642
• DOI: 10.1002/dmrr.2479
• Languages: English
• ISSNs: 1520-7552

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="dmrr2479-sec-0001" sec-type="section"> <title>Context</title> <p>Type 2 diabetes has reached epidemic proportions and places a heavy burden on society. Dapagliflozin is a novel treatment choice for type 2 diabetes.</p> </sec> <sec id="dmrr2479-sec-0002" sec-type="section"> <title>Objective</title> <p>A meta‐analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy and safety of dapagliflozin treatment.</p> </sec> <sec id="dmrr2479-sec-0003" sec-type="section"> <title>Data Sources</title> <p>Medline (via PubMed), Embase (via OVID) and the Cochrane Library (up to August 2012) were searched, and RCTs were collected.</p> </sec> <sec id="dmrr2479-sec-0004" sec-type="section"> <title>Study Selection</title> <p>Studies included type 2 diabetic subjects, who had been treated with dapagliflozin, and recorded HbA<sub>1c</sub> as outcomes.</p> </sec> <sec id="dmrr2479-sec-0005" sec-type="section"> <title>Data Extraction</title> <p>Two reviewers independently assessed articles and study quality. Patient characteristics, interventions and outcomes were collected.</p> </sec> <sec id="dmrr2479-sec-0006" sec-type="section"> <title>Data Synthesis</title> <p>Ten RCTs were included. Risk of bias for outcomes was low. Fixed or random effects models were used to pool the results. Dapagliflozin treatment was associated with a reduction in HbA<sub>1c</sub> [weighted mean difference (WMD): –0.53%; 95% confidence interval (CI): −0.58% to −0.47%; <italic>p</italic> < 0.00001], fasting plasma glucose (WMD: −1.06 mmol/L; 95% CI: −1.20, −0.92; <italic>p</italic> < 0.00001), and body weight (WMD: −1.63 kg; 95% CI: −1.83, −1.43; <italic>p</italic> < 0.00001). Dapagliflozin monotherapy did not lead to hypoglycaemia [relative risk (RR): 1.44; 95% CI: 0. 86, 2.41; <italic>p</italic> = 0.17], although hypoglycaemic risk increased (RR: 1.16; 95% CI: 1.05, 1.29; <italic>p</italic> = 0.005) when dapagliflozin was combined with other hypoglycaemic drugs. Dapagliflozin increased urinary glucose excretion (WMD: 26.98; 95% CI: 21.72, 32.24; <italic>p</italic> < 0.00001) and was associated with an increased risk of urinary tract infections (RR: 1.33; 95% CI: 1.10, 1.60; <italic>p</italic> = 0.004) and genital tract infections (RR: 3.23; 95% CI: 2.50, 4.18; <italic>p</italic> = 0.00001).</p> </sec> <sec id="dmrr2479-sec-0007" sec-type="section"> <title>Conclusions</title> <p>Dapagliflozin appears to be an effective treatment for type 2 diabetes, although it may increase the risk of urinary tract infections and genital tract infections. Copyright © 2013 John Wiley & Sons, Ltd.</p> </sec> </abstract>